Martha Louise Boehm, M.ED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-27477 Issued in FL

Practice address

8700 Rolling Brook LN
Jacksonville, FL 32256-9024

Phone

(904) 716-3065

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Martha Louise Anlage Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fostering Behavior

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1205500592
  NPD Authorized official
• Behavioral Solutions Consulting, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1104260488
  NPD (past)
• Junior Boom ABA LLC

  • Behavior Analyst
  • Brooklyn, NY
  • NPI 1861194490
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1124433776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11953 OLDFIELD POINTE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322233512",
            "telephone_number": "904-578-7767",
            "fax_number": "904-578-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 ROLLING BROOK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569024",
            "telephone_number": "904-716-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "MARTHA",
        "middle_name": "LOUISE",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-17-27477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "ANLAGE",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aleena Bodoe, DMFT
• Body Balance MD
• Bodywonder, Inc.
• Kaela Boe, MSN APRN FNP-BC
• Elizabeth Boehling
• Alison Boehnke, BS
• Lynsie Ann Boelsche, BCBA
• Charles Francis Boelter, PA-C
• Caitlin P Boera, 103K00000X
• Sarah Boesel, PT

• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.